“Piece of Mind” and “Wellbeing Town”

The long-term implications of COVID-19 for wellbeing are predicted to be both significant and enduring. Data from previous epidemics indicates long-term detrimental effects are more pronounced among particular demographics, including individuals with pre-existing mental health conditions. The Mental Health Independent Support Team (MhIST) is a charitable organisation offering a range of free-at-the-point-of-contact services via self-referral for a range of mental health and wellbeing concerns, both with and without diagnosis. Since March 2020, the organisation noted significant rises in demand for services. Serious games and their active involvement in eliciting rapid positive behavioural change is associated with their emergence as a key learning tool, with effects transferable to the real world. While a growing number of gamified interventions exist for a range of mental health diagnoses, their presence in the domain of positive psychology is more limited. The chapter reports two studies conducted to enhance the development of an educational game for adult wellbeing.

Difficulties in Addressing Artificial Hydration and Nutrition Therapy for Terminal Cancer Patients: What to do if Patients/Families’ Wishes Differ From the Medically Appropriate Treatment Plans?

Purpose: Artificial hydration and nutrition therapy (AHNT) initiated by patients/families sometimes differs from medically appropriate treatment plans. We aimed to identify the causes of these differences and examine the ensuing responses and outcomes. Methods: Of 133 adult cancer patients receiving end-of-life care in the last 2 years, these discrepancies occurred in 41 patients. We retrospectively examined the following issues: (1) The reason why these discrepancies occurred. (2) Based on the causes identified in (1), the following actions were taken: 1) If the consent to change to medically appropriate AHNT was obtained, physical findings using Japan Palliative Oncology Study (JPOS) group and Edmonton Symptom Assessment System (ESAS) were compared before and 1 week after the intervention. 2) If consent was not obtained, time-limited trial (TLT) was conducted, and these results were compared. (3) The communication between patients/families and medical professionals was compared using Support Team Assessment Schedule. Results. (1) Causes: a) the lack of understanding of the disease condition in 26 cases and b) faulty expectation of AHNT in 15 cases. (2) In 30 cases of 1) (20 of a) and 10 of b)) and 11 of 2) in which TLT was performed, JPOS and ESAS improved significantly. (3) The communication above was improved significantly in 1) and 2) ( P = .0027 and .0039, respectively). Conclusion. Providing medically appropriate AHNT with the consent of patients/families is expected to not only alleviate distressing symptoms but also improve the communication between patients/families and medical professionals, as well as improve the quality of palliative care.

Evaluation the Role of Nutrition Support Team for Monitoring the Types, Complication, Nutrients and Drugs Provision in the Parenteral Nutrition

Parenteral nutrition (PN) is a form of administering nutrients, include water, macro and micronutrients and is one of widely used mode of therapy used in patients who are unable to tolerate oral or enteral feeding. Therefore, the success of nutritional therapy depends chiefly on nutrition support teams. The aim of the present work to evaluation the provision of parenteral nutrition in the Benghazi medical center. A total of 86 patients were involved in the study and numbers of questions were answered from nutrition support team at the hospital. The result revealed that PPN (IV drip) most common used and mixture of dextrose and sodium chloride were highly provision in the hospital. Furthermore the Doctors at the ward were shown have fully responsibility for provided PN but there were neglected role of dietitian and pharmacist. Patients monitoring were not carried out routinely. Most drug delivered by PN found NSAIDs and insulin. Dextrose and sodium chlorides commonly used in the hospital for delivery medication. The present study also demonstrated that, PN did not fulfill the patients requirement and there were no patients monitoring. PN found to be used most frequently in some condition were where in real need such as pulmonary disease, GIT disorder and renal disease. Furthermore, TPN provided for the admitted patients include in emergencies, therapeutic and for unconscious patients. There were reported a number of complication in patient received PN due to lack of monitoring and prolong replacements of PN drainage. PPN (Iv drips) were the most common uses at the hospital and longer duration was proved which might led to patients burden in the hospital. Furthermore, due to the uses of PPN for longer times this could contribute for patients malnutrition. Our data suggested that, comprehensive nutrition support team and provision of intervention programs in order to increased quality and reduced patients burden and also the result of our study needed to be validated in large sample to know the real role of dietitian and pharmacist for ordered of drugs and nutrients and nutrients drug interactions. Keywords: Nutrients, Provision, TPN, PN, complication, medications.

A Conceptual Framework for Analysing Partnership and Synergy in a Global Health Alliance: Case of the UK Public Health Rapid Support Team (UK-PHRST)

ABSTRACT Partnerships have become increasingly important in addressing complex global health challenges, a reality exemplified by the COVID-19 pandemic and previous infectious disease epidemics. Partnerships offer opportunities to create synergistic outcomes by capitalising on complimentary skills, knowledge and resources. Despite the importance of understanding partnership functioning, research on collaboration is sparse and fragmented, with few conceptual frameworks applied to evaluate real-life partnerships in global health. In this study, we aimed to adapt and apply the Bergan Model of Collaborative Functioning (BMCF) to analyse partnership functioning in the UK Public Health Rapid Support Team (UK-PHRST), a government-academic partnership, dedicated to outbreak response and research in low- and middle-income countries. We conducted a literature review identifying important elements to adapt the framework, followed by a qualitative case study to characterise how each element, and the dynamics between them, influenced functioning in the UK-PHRST, exploring emerging themes to further refine the framework. Elements of the BMCF that our study reinforced as important included the partnership’s mission, partner resources (skills, expertise, networks), leadership, the external environment, management systems, and communication. Additional elements identified in the literature and critical to partnership functioning of the UK-PHRST included governance and financial structures adopted, trust and power balance, organisational culture, strategy, and evaluation and knowledge management. Because of the way the UK-PHRST was structured, fostering team cohesion was an important indicator of synergy, alongside collaborative advantage. Dividing the funding and governance equally between organisations was considered crucial for maintaining institutional balance, however, diverse organisational cultures, weak communication practices and perceived power imbalances compromised team cohesion. Our analysis allowed us to make recommendations to improve partnership functioning at a critical time in the evolution of the UK-PHRST. The analysis approach and framework presented here can be used to evaluate and strengthen the management of global health partnerships to realise synergy.

Opioid use disorder from poppy seed tea successfully treated with buprenorphine in primary care: a case report

Background Poppy seeds contain morphine and other opioid alkaloids and are commercially available in the United States. Users of poppy seed tea (PST) can consume several hundred morphine milligram equivalents per day, and opioid dependence from PST use can develop. We report a case of a patient with chronic pain and PST use leading to opioid use disorder (OUD). This case represents the first published report of OUD from PST successfully treated with buprenorphine (BUP) in a primary care setting. The provider in this case used a unique model of care with an opioid prescribing support team to deliver safe and effective care. Case presentation A 47-year-old man with chronic pain and prescription opioid use presented to primary care to discuss a flare of shoulder pain, and revealed in subsequent conversation a long-standing use of PST to supplement pain control. Attempts at cessation resulted in severe withdrawal symptoms, leading to return to PST use. The primary care provider consulted the VA Puget Sound SUpporting Primary care Providers in Opioid Risk reduction and Treatment (SUPPORT) team to evaluate the patient for OUD. The patient discontinued all opioids, and initiated BUP under the supervision of the primary care provider. He remained on a stable dosage, without relapse, 24 months later. Conclusions PST, which can be made through purchase of readily available poppy pods, carries risk for development of OUD and overdose. Herein we highlight the utility of a primary care opioid prescribing support team in empowering a primary care provider to prescribe BUP to treat a patient with complex OUD.

Experiential learning placements in primary care: Responding to the COVID-19 pandemic

In 2020, the Sars-2-CoV pandemic led to challenges in providing experiential learning (EL) placements for undergraduate student pharmacists in primary care settings across Scotland. The need to reduce footfall along with the introduction of physical distancing measures, a blended approach to working location, and a change to workflow, all created unforeseen challenges for hosting student pharmacist EL placements within the primary care environment in NHS Lanarkshire. This short report focuses on how the primary care prescribing support team in NHS Lanarkshire adapted student pharmacist EL placements to ensure they continued to meet learning outcomes as defined by the universities via virtual delivery hosted on MS Teams.

Understanding Matchmakers’ Experiences, Principles and Practices of Assembling Innovation Teams

The team composition of a project team is an essential determinant of the success of innovation projects that aim to produce novel solution ideas. Team assembly is essentially complex and sensitive decision-making, yet little supported by information technology (IT). In order to design appropriate digital tools for team assembly, and team formation more broadly, we call for profoundly understanding the practices and principles of matchmakers who manually assemble teams in specific contexts. This paper reports interviews with 13 expert matchmakers who are regularly assembling multidisciplinary innovation teams in various organizational environments in Finland. Based on qualitative analysis of their experiences, we provide insights into their established practices and principles in team assembly. We conceptualize and describe common tactical approaches on different typical levels of team assembly, including arranging approaches like “key-skills-first”, “generalist-first” and “topic-interest-first”, and balancing approaches like “equally-skilled-teams” and “high-expertise-teams”. The reported empirical insights can help to design IT systems that support team assembly according to different tactics.

Factors Related to Oral Intake of Food by Hospitalized Patients with Malnutrition under the Care of a Nutrition Support Team

This study aimed to evaluate the role of the general condition and oral health status in determining the primary nutritional route and suitable food form for oral ingestion among malnourished inpatients. This cross-sectional study included 255 inpatients referred to a nutrition support team (NST), which included dental professionals, at an acute care hospital. We assessed the participants’ basic information, and Dysphagia Severity Scale (DSS) and Oral Health Assessment Tool (OHAT) scores. The nutritional intake mode was evaluated based on the Functional Oral Intake Scale scores at the initial NST consultation (FOIS-I), and then revised by the NST based on the participants’ general condition and oral health (FOIS-R). There was a divergence between FOIS-I and FOIS-R, with FOIS-R being significantly higher than FOIS-I (p < 0.001). Logistic regression analysis of FOIS-R identified that consciousness level (odds ratio (OR): 0.448; 95% confidence interval (CI): 0.214–0.935) and DSS (OR: 3.521; 95% CI: 2.574–4.815) significantly affected the oral nutrition intake. Among participants who could ingest orally (FOIS-R ≥ 3; n = 126), FOIS score had significant negative and positive associations with the OHAT and DSS scores, respectively. These findings suggest that appropriate assessment of oral health status, including swallowing function, might contribute to high-quality nutrition management.

The development of the rehabilitation community transition support team as a response to COVID-19

Background/aims The rehabilitation community transition support team was created as a response to the COVID-19 pandemic, resulting in faster discharges from the inpatient rehabilitation service. The aim of this evaluation was to explore the perspectives of staff and patients on their experience of the rehabilitation community transition support team. Methods Staff and patients in the new team were interviewed using semi-structured interviews. The data were analysed using thematic analysis. Results Staff interviews generated seven main themes: positive staff experiences; defining the ‘team’; mode of working; link role for the team; technology; relationships with patients; and support from colleagues. The patient analysis generated five themes: positive experiences of the rehabilitation community transition support team; relationship with rehabilitation community transition support team worker; mode of working; handling the hurdles of discharge; and defining the ‘team’. There were crossovers of staff and patient themes, particularly surrounding around face-to-face visits, defining the team and relationships. Patients indicated that contact with the community team helped them to overcome both practical and emotional hurdles of discharge. Conclusions The presence of a team supporting the transition from hospital to a community setting may be helpful for people who have been discharged.